LAURA A. CHRISTEN, Employee/Appellant, v. SHERBURNE COUNTY, SELF-INSURED, adm'd by MINNESOTA COUNTIES INS. TRUST/RSKCo., Employer-Insurer, and MN DEP=T OF ECON. SEC., MAYO FOUND., ST. CLOUD ORTHO. ASSOCS., ST. CLOUD HOSP./CENTRA CARE HEALTH SYS., and HEALTHPARTNERS, Intervenors.

 

WORKERS= COMPENSATION COURT OF APPEALS

FEBRUARY 10, 2004

 

HEADNOTES

 

CAUSATION - SUBSTANTIAL EVIDENCE.  Substantial evidence, including expert medical opinion, supports the compensation judge=s finding that the employee=s work injury of August 21, 2000, was temporary, and the judge=s denial of the employee=s claims for wage loss benefits and medical expenses.

 

Affirmed.

 

Determined by Johnson, C.J., Wilson, J., and Stofferahn, J.

Compensation Judge: Jeanne E. Knight

 

Attorneys:  Mark R. Black, Black Law Office, Ltd., St. Cloud, MN, for the Appellant.  Jeffrey G. Carlson and Carrie I. Jacobson, Brown & Carlson, P.A., Minneapolis, MN, for the Respondents.

 

OPINION

 

THOMAS L. JOHNSON, Judge

 

The employee appeals the compensation judge=s finding that her August 21, 2000, neck injury was temporary in nature and the compensation judge=s denial of the employee=s claims for wage loss benefits and medical expenses.  We affirm. 

 

BACKGROUND

 

Laura A. Christen, the employee, sustained an injury to her neck on August 21, 2000, while working for Sherburne County, the employer, self-insured for workers= compensation liability through Minnesota Counties Insurance Trust/RSKCo.  Initally, the employer admitted liability for a personal injury, but later contended that all workers= compensation benefits paid to the employee were paid under a mistake of fact.^[1]

 

Prior to the injury, in May 1998, the employee had received six treatments at Brennan Chiropractic Health Center for complaints of neck pain with radiating pain into her left arm.  On September 30, 1999, the employee again sought treatment at Brennan Chiropractic complaining of right arm numbness and head and neck pain.  She returned to Brennan Chiropractic on August 17, 2000, complaining of neck pain and tingling in her left hand and arm.  The doctor diagnosed a thoracic strain and provided chiropractic treatment.  On August 18, the doctor noted she was a little better.

 

On August 21, 2000, the employee sought treatment from J. Pollpnick, D.C., at Clearwater Chiropractic, complaining of stiffness in her neck and pain into her arm.  The doctor performed muscle stimulation, diathermy and adjustments.  That same day, the employee saw Dr. Kurt R. Lemke at St. Cloud Medical Group.  She gave a history of increasing left-sided neck pain over the past week but did not recall an acute injury.  An x-ray showed cervical spondylosis, moderate degenerative disc disease and uncinate process disease with mild neural foraminal narrowing at C5-6 and C6-7 with loss of normal cervical lordosis.  Dr. Lemke diagnosed neck pain with left arm radiculopathy likely due to a strain and degenerative joint disease.  The doctor prescribed anti-inflammatory medication and physical therapy.

 

An MRI scan in September 2000 showed multiple level disc degeneration, a right-sided disc protrusion at C5-6 which contacted the ventral surface of the spinal cord, a central and left-sided disc protrusion at C6-7 which contacted the ventral surface of the cord, and mild left-sided foraminal narrowing due to an uncinate spur.  The employee returned to see Dr. Lemke on September 18, 2000, with complaints of steadily worsening neck and arm pain which she attributed to lifting heavy rocks at work in August 2000.  On September 27, Dr. Lemke diagnosed a cervical strain and cervical disc injury with significant disc herniations and protrusions which he related to an injury on August 21, 2000.  The doctor took the employee off work pending a consultation at the Mayo Clinic. 

 

The employee was seen at the Mayo Clinic, and in November 2000, Dr. W. R. Marsh performed a left sixth cervical partial hemilaminectomy and foraminotomy to correct a C-6 foraminal stenosis.  In May 2001, the employee began seeing Dr. Andrea Boon at the Mayo Clinic who diagnosed cervical myofascial pain and resolving left rotator cuff tendinitis, which Dr. Boon related to the cervical injury.  The employee reported she had been working since May 15, 2001, but complained of significant pain between her shoulder blades.  On July 16, 2001 Dr. Boon=s diagnoses were unchanged.  The doctor felt the employee could not return to heavy manual labor and limited the employee to no lifting, pushing or pulling greater than five pounds, only occasional repetitive gripping or pinching and occasional bending and stooping.

 

The employee began treating with Dr. Mark Thibault, a physiatrist, in August 2001.   By report dated May 2, 2002, Dr. Thibault stated his final diagnoses were chronic myofascial neck and upper back pain and chronic residual stable left C-7 radiculopathy.  The doctor related these diagnoses to the employee=s August 21, 2000 injury.  Dr. Thibault rated a ten percent whole body disability and released the employee to return to work, with restrictions.

 

The employee was examined by Dr. Peter Daly in October 2001 at the request of the respondents.  The doctor diagnosed cervical myofascial pain and a history of left shoulder impingement with no objective pathology.  Dr. Daly noted the employee had a documented history of left neck and arm pain, including numbness and tingling involving her hand and arm, prior to the August 21, 2000 work injury.  The doctor concluded the employee=s neck and left arm symptoms were caused by pre-existing degenerative disc disease and degenerative foraminal narrowing which were not substantially altered by her work activities on August 21, 2000.  The doctor opined the decompression surgery in November 2000 was required to treat the pre-existing degenerative condition.  Dr. Daly stated the employee was able to work, with restrictions, but the need for restrictions was related to her pre-existing degenerative disc disease.

 

 The employee returned to Dr. Marsh at the Mayo Clinic in December 2002.  The doctor reviewed a current MRI scan which continued to show degenerative disc disease at C-5 and C-6 with no clear nerve root compression.  The employee was also seen by Dr. Michael P. Schaefer, a physiatrist, who diagnosed left C5-C6 radiculopathy and cervical myofascial pain.  Dr. Schaefer increased the employee=s dosage of Neurontin and recommended additional physical therapy. 

 

An EMG in January 2003, requested by Dr. Marsh, showed evidence of a chronic left C-7 radiculopathy, without significant uncompensated denervation.  In February 2003, Dr. Marsh performed an anterior cervical discectomy and fusion at C6-7.

 

On April 22, 2003, Dr. Edward W. Szalapski Jr. examined the employee at the request of the employer.  Dr. Szalapski diagnosed degenerative disc disease at C5-6 and C6-7 which resulted in cervical radiculopathy into the left arm.  The doctor concluded this was a pre-existing condition not consistent with an injury on August 21, 2000.  The doctor opined the two surgeries were necessary to treat the employee=s pre-existing condition and did not result from any work injury.  The doctor stated the employee could return to sedentary or light work and rated permanent disability.

 

The employee filed a claim petition in August 2001, later amended, seeking payment of medical expenses, wage loss benefits and permanent partial disability benefits.  In a Findings and Order filed July 28, 2003, the compensation judge found the medical treatment to the employee=s neck, including the two surgeries, and the related temporary total and temporary partial disability, was due to the employee=s pre-existing degenerative disc disease, and denied the employee=s claims.  The employee appeals.

 

DECISION

 

The employee contends the compensation judge=s decision is unsupported by substantial evidence.  She argues she had few symptoms prior to the August 21, 2000 injury but required significant medical care thereafter, including two surgeries.  Prior to the injury, the employee contends she was able to work without restrictions but is now limited due to the work injury.  Finally, the employee points to the medical opinions of Dr. Marsh and Dr. Thibault causally relating the employee=s need for medical treatment to the personal injury.  Accordingly, the employee seeks a reversal of the compensation judge=s denial of the requested benefits.  We are not persuaded.

 

Certainly, there is evidence of record which, if accepted by the compensation judge, would support an award of benefits in this case.  On appeal, however, the issue is not whether the evidence would support a contrary result but whether the findings of fact and order are clearly erroneous and unsupported by substantial evidence.  Minn. Stat. ' 176.421, sub. 1 (1992).  Substantial evidence supports the findings if, in the context of the entire record, Athey are supported by evidence that a reasonable mind might accept as adequate.@  Hengemuhle v. Long Prairie Jaycees, 358 N.W.2d 54, 59, 37 W.C.D. 235, 239 (Minn. 1984).

 

Prior to the August 21, 2000 personal injury, the employee sought medical care complaining of neck pain with tingling into her left hand and arm.  An x-ray on August 21, 2000 showed cervical spondylosis and degenerative disc disease with foraminal narrowing at C5-6 and C6-7.  An MRI scan in September 2000 showed disc protrusions at C5-6 and C6-7 with foraminal narrowing.  These conditions clearly pre-dated the employee=s work injury.  Both Dr. Daly and Dr. Szalapski opined the employee=s need for medical treatment was due to her pre-existing condition, not any work injury.  Although there is expert testimony to the contrary, it is the function of a compensation judge as the trier of fact to choose between conflicting expert opinions.  See Nord v. City of Cook, 360 N.W.2d 337, 342, 37 W.C.D. 364, 372 (Minn. 1985).  Substantial evidence supports the compensation judge=s decision and we must, therefore, affirm.